Health inspection·May 29, 2025

F 0605 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on the interview and record review, the facility failed to ensure that residents are free from chemical restraints related to PRN orders for psychotropic drugs are limited to 14 days. Except as provided in §483.45(e)(5), if the attending physician or prescribing practitioner believes that it is appropriate for the PRN order to be extended beyond 14 days, he or she should document their rationale in the resident's medical record and indicate the duration for the PRN order, for 1 of 3 residents (Resident #132) reviewed for chemical restraint, in that: The facility failed to ensure Resident #132 was prescribed a psychotropic drug for anxiety, no longer than 14 days PRN (as needed). This failure could place residents at risk of receiving unnecessary psychotropic medications. The findings were: Record review of Resident #132's face sheet, dated 5/27/25, revealed the resident was admitted to the facility on [DATE] with the diagnoses that included: hypertension (medical term used when the force of your blood against arterial walls is consistently too high), asthma (condition in which a person's air ways becomes inflamed, which makes it difficult to breath), and anxiety disorder (mental condition characterized by excessive and persistent feelings of fear, that significantly interferes with daily life function). Record review of Resident #132's BIM's assessment, completed 5/27/25, revealed a BIM's score of 15, which indicated cognition was intact. Record review of Resident #132's care plan, dated 5/26/25, revealed the resident uses antianxiety medication Xanax with interventions to administer medicines as ordered by a physician. Record review of Resident #132 order summary, dated May 2025, revealed an order for Xanax oral tablet 0.5 mg, give one tablet by mouth every 8 hours as needed for anxiety indefinite. Record review of the medication administration record for Resident #132, dated 05/27/25, revealed Resident #132 had received Xanax 0.5 mg on 5/24/25 @ 2300 and on 5/26/25 @ 1343. Interview with Resident #132 on 5/26/25 at 12:03 PM, revealed the resident took this anxiety medication at home but could not recall the name at this time, but knew the facility staff give it to her at this facility. (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 6 Event ID: 676303 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 676303 B. Wing A. Building (X3) DATE SURVEY COMPLETED 05/29/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Mirador 5857 Timbergate Dr Corpus Christi, TX 78414 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)